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Northeast Regional Director Resume Example

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NORTHEAST REGIONAL DIRECTOR
Executive Profile
Highly motivated and hard working professional committed to providing positive outcomes.
Skill Highlights
  • Project Management
  • Revenue Cycle Management
  • Team Player
  • Time Management 
  • Training and Management Information System
  • Excellent organizational skills
  • Excellent critical thinking skills
  • Able to multi-task
Core Accomplishments
Project Management:
  • Initiated Pennsylvania transition of AS/400 into MyAvatar which resulted in our enabling our clinicians to input notes electronically, advanced billing software package, decrease in claim rejection and increase in revenue.
  • Complete analysis of Northeast Revenue Cycle Management Department using a SWOT analysis.  Implemented a process improvement plan which included steps to improve staff retention, update policies and procedures and ensure consistent revenue flow.
Professional Experience
June 2005
to
Current
Revenue Cycle Management Children's Behavioral Health, IncJohnstown, PennsylvaniaNortheast Regional Director
  • Ensuring the efficient operation of the AS/400 Management Information System and other software applications as they relate to all aspect of the claims life span for three companies.
  • Responsible for setting up new programs in electronic medical records system (Avatar).
  • Duties include setting up programs including services codes, guarantors, and general ledger mapping.
  • Lines of business include outpatient mental health clinics, children's partial hospitalization, family based clinics, behavioral health rehabilitative services, crisis residential, behavior support systems, and intellectual disabilities program which includes day treatment and residential.
  • Supervising a team consisting of one medical biller/follow-up specialist supervisor, three cash posters, two authorization/utilization management specialist, and eight medical biller/follow up specialist.
  • The goal is to ensure assigned job tasks are done in accordance with acceptable billing procedures, company policies and procedures, and government regulations.
  • Follow through on compliance mandates regarding improper billed services and ensure payers receive reimbursement.
  • Generation of semimonthly and monthly reporting for upper management's review and reporting.
  • Creation of accounts receivables spreadsheet summarizing monthly changes in accounts receivables aging to identify positive and negative trends.
  • Communication with payers and attendance at meetings to facilitate and maintain a billing mechanism which operates without interruption in an efficient organized manner.
July 1999
to
July 2005
Nulton Diagnostic and Treatment CenterJohnstown, PennsylvaniaDirector of Billing
  • Implementation of Medisoft billing software to enhance the business operations.
  • Ensured a constant flow of revenue into the company.
  • Responsible for managing the day-to-day operations of the billing department.
  • Supervised a team four medical billers, cash posters, and follow up personnel.
  • Lines of business included outpatient mental health clinics, children's partial hospitalization, family based clinics, and behavioral health rehabilitative services.
  • Credentialing with third-party payers to provide behavioral health services to their members.
September 1996
to
June 1999
Highmark Blue Cross Blue ShieldJohnstown, PennsylvaniaSecretary
  • Responsible for providing administrative support to the Clinical Consultants and Manager.
  • Developed internal and external training programs for Clinical Consulting Services.
  • Coordinated monthly calendar and development of database to track Clinical Consultants physician visits and training.
  • Conducted research thru ICS and ROAR mainframe to solve physician issues.
  • Trained new staff in the various computer software packages and telephone system.
  • Worked with Sales/Marketing Department and Member Services to resolve issues and ensure open communication.
June 1991
to
October 1994
Sargent's Court ReportingJohnstown, PennsylvaniaMedical Transcriptionist
  • Responsible for transcribing cassette tapes and stenographer notes for Workmen's Compensation Cases.
  • Proofreader for quality assurance and accuracy.
Education
January 2016
Capella UniversityMaster's Degree: Business AdministrationBusiness Administration
May 2011
University of PhoenixBachelor's Degree: Healthcare Administration and Information TechnologyHealthcare Administration and Information Technology
December 2008
Axia College, University of PhoenixAssociate's of Arts Degree: Health Care AdministrationHealth Care Administration
Professional Affiliations
Delta Mu Delta International Honor Society in Business
Skills
accounts receivables, administrative support, AS/400, behavioral health, billing, Consulting, critical thinking, database, electronic medical records, general ledger, government, government regulations, notes, mainframe, managing, Marketing, medical billing, meetings, mental health, office, Microsoft Office products, Management Information System, organizational skills, personnel, policies, posters, proofreader, quality assurance, reporting, research, Sales, spreadsheet, supervisor, Supervising, Team player, telephone, training programs
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Resume Overview

Companies Worked For:

  • Revenue Cycle Management Children's Behavioral Health, Inc
  • Nulton Diagnostic and Treatment Center
  • Highmark Blue Cross Blue Shield
  • Sargent's Court Reporting

School Attended

  • Capella University
  • University of Phoenix
  • Axia College, University of Phoenix

Job Titles Held:

  • Northeast Regional Director
  • Director of Billing
  • Secretary
  • Medical Transcriptionist

Degrees

  • Master's Degree : Business Administration
    Bachelor's Degree : Healthcare Administration and Information Technology
    Associate's of Arts Degree : Health Care Administration

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